The Impact of Department Culture on Fireground Safety

We’ve spent countless hours training our firefighters to perform operations in a specific, safe way; yet, some of them still take risks that are totally unnecessary. We’ve purchased for them the finest firefighting gear, and some of them do not wear it on emergencies. We’ve provided them with radios, and they don’t communicate. We’ve had our apparatus built with antilock brakes and seat belts, because we know that driving is hazardous; and they just drive faster and don’t wear the seat belts. We tell them to assess and balance risk; instead, they seem to seek it. We have written policies that say “don’t,” and they sometimes still “do.”

Such are the laments of fire administrators across the country. In one way or another, most of us have experienced firsthand that unseen driving force that influences intelligent, well-trained firefighters to suddenly take risks that defy safe firefighting practices. Although this may seem mysterious on the surface, if we were to look more deeply into this phenomenon, we likely would find that these behaviors could be attributed to the organization’s culture-more specifically, its culture of safety.

There’s been a lot of talk about a culture of safety in the fire service over the past few years, but such a culture can seem a bit elusive. It may not necessarily stand out as “culture” at first glance. Like the wind, you know it’s there; you can see its impact, but you don’t necessarily see “it.” What we ultimately see is the result of a culture of safety-consistently safe behaviors. Although we all strive for such a culture, obtaining it is a whole different story.


Some foundational elements must be in place before we can attain the goal of consistently behaving in a safe manner. Placing these elements in perspective can be done by viewing each element as a progressive level. Starting at the bottom, each lower level must be met before moving to the next higher level (Figure 1). The first stage (beginning at the bottom of the pyramid) is to establish a duty to act; it should be followed by identifying the risks associated with the duty to act, establishing safety systems appropriate for the identified risks, and establishing a culture of safety.

To achieve reliably safe behaviors in a fire service organization, certain foundational elements must first be in place. The above diagram is based on the concept that elements at the bottom of the pyramid must be functionally in place before higher levels can be logically or functionally reached (much like Abraham Maslow’s “Hierarchy of Needs” theory). Although some degree of leadership is necessary at all levels, it is critical in establishing a climate and culture of safety. Elements in this level must be in place if consistently safe behaviors are going to occur.
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1 Identify your duty to act. This step involves identifying the fire and emergency services your citizens should reasonably expect from your department. This may seem too fundamental a starting point, but consider how many times firefighters conduct seat-of-the-pants, ad hoc operations because when no one else is available to fix a situation, the public calls the fire department. No doubt, it’s an honor to be there for our citizens; but from a safety perspective, firefighters should not have to wake up each day and wonder, “Exactly what will I be expected to do today?” When you do not determine the services you can reasonably deliver to your community-and make the public aware of that information-you run the risk of engaging in “last-minute” operations for which you are neither equipped nor trained.

2 Identify the risks associated with the duty to act. Thoroughly analyze the tasks your organization expects to perform, identify the hazards associated with those tasks, and articulate these risks to the responders expected to perform these tasks. Do this before the alarm comes in, and then constantly reevaluate the data to ensure that even subtle changes are identified and appropriately addressed. Establish that your organization will not be able to immediately control some hazards. Although total inaction is usually not an option, slowing down, defining the risks, and establishing a reasonable safe game plan are options.

3 Establish safety systems to address the identified risks. This step encompasses much of what we usually consider “running the fire department.” Now that you have identified the risks associated with performing job tasks, you must establish systems that will prepare and equip your people to safely work in those environments. This stage includes personal protective equipment, communication equipment, training, safety policies, staffing, and resource allocation, to name a few. Essentially, this is where you make sure that you have all the right things. It does not, however, ensure that you will always do the right things.

Interestingly, many organizations stop the process here and expect to see consistently safe behaviors because they acquired the latest equipment, wrote safety policies, held training sessions, and have an adequate supply of personnel. Unfortunately, they still see behaviors that are not safe, because they did not take the next step in the safety continuum, establishing a culture of safety.

4 Establish a culture of safety. A culture of safety involves altering human behaviors in addition to initiating a system. As illustrated in Table 1, leaders in organizations with a well-established culture of safety focus on how they address the members and making sure that members’ actions are within the context of safety.

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In this bridge between having the right things and doing the right things, the leaders in a culture of safety are vigilant in observing all aspects of operations from subtle anomalies to big neon signs that indicate changes in safety-related issues or behaviors. As fire service professionals, we generally recognize the signs and symptoms that indicate that safety issues need to be addressed. However, choosing to deal with the issues in an effective and consistent manner can be quite another story. Strong leadership must be the linchpin for establishing a safe culture, which is not a mission for the meek.

Interestingly, the problem with leadership at this level is not necessarily that it is absent, as some suggest. In fact, in many organizations, there seems to be plenty of leadership driving the organizational culture. The problem is that it’s not always the right leadership. Typically, when we identify the characteristics of a leader, we envision a bold, charismatic, technically competent individual who is able to draw people together and mobilize them in a single direction. Certainly, these would be considered solid characteristics of a leader.

However, what we often overlook is the direction in which these leaders are taking the organization. If your organization’s leaders, whether from the formal or informal group, are taking members to a place where risky behavior is rewarded more than safe operations, your organization’s culture will reflect that. In spite of all the efforts made to master the first three steps in the pyramid, it is highly unlikely that consistently safe behavior will be achieved if the prevailing culture is fighting against going in that direction.

Whether an organization will realize consistently safe behaviors or not ultimately will depend on the quality of the leadership and the values held by the strongest leaders steering the organization’s culture of safety, not on whether leadership is absent.


What do the leaders who lead organizations to a culture of safety look like? First, they set the pace. They understand that when you lead, everything you say and do is amplified in the organization’s eyes. Therefore, effective leaders ensure that they are stellar role models of safe behaviors at all times. They understand that there cannot be even small lapses in their safe behaviors during emergency operations, training, or even in casual conversation. If they should slip up, they will not ignore or downplay it. Instead, they, themselves, will call attention to it. They know that if they don’t, others will; and they probably won’t be sending the message in the way the leader wants.

Next, when effective leaders see a safety infraction or problem, they act to correct it every time-not some of the time or depending on who’s involved. Effective leaders know what it’s like to take an unpopular stand. However, they also know that inconsistent or weak leadership in the realm of safety issues can be a license to kill. What you allow, you encourage.

Effective leaders in a culture of safety also pay attention. They keep abreast of the safety issues facing their people. They stay current on industry trends. They look below the surface when observing operations and challenge members to make safer even operations that seem safe.

Leaders in a culture of safety find ways to reward safe behavior. Many times, leaders tend to overlook a safely run operation because it appears that “nothing” really happened: Things were done correctly, and everything went as planned. Conversely, when a bad outcome occurs because of a safety infraction, we give it plenty of attention. The end result is that people in the organization know a lot about the behaviors we don’t want but not enough about those we do want. Leaders of safe cultures find ways to make the desired behavior known by defining it, seeking it, finding it, and rewarding it as publicly as possible.

All members of the organization must play a part in this leadership role. It does no good to have the chief of a department set up rewards for responsibly managing risks if the remainder of the organization rewards members for indulging in risks. In a safety culture, the value and reward systems for safe behaviors are similar at all levels of the formal and informal organizational structure. A good leader knows this, communicates it, and monitors it constantly.

Does this sound lofty or a little too idealistic? It may not if you step back from your immediate culture for a moment to get a different view. There is evidence that the fire service is moving toward a culture of safety. Near-miss reporting and safety stand downs are two good examples of this, but there is still a lot of work to be done. Looking outside the fire service, there are some great examples of high-risk industries-offshore oil drilling, commercial airlines, and nuclear power plants, for example-that have made significant progress toward establishing a culture of safety. There is also a significant body of research that provides compelling evidence showing that developing and maintaining a safe culture can be done and that it effectively promotes safe behaviors. However, nothing indicates that it will be easy or quick work. We’re going to have to get our hands dirty. So, if we accept that it can be done, the real question comes down to how bad we really want it. Actions, not words, must convey our answer.


As the well-known risk management advocate and educator Gordon Graham accurately stated, “Things that go wrong in life are highly predictable, and if predictable they are preventable. Fire service operations are not an exception to this rule. Predictable is preventable.”

Graham’s quote applies to leadership intervention on the fireground. It is easy to recognize what can happen on the fireground when individuals have not established a duty to act, identified and understood the risks involved, and established adequate and appropriate safety systems to address the identified risks.

The building blocks of the culture of safety pyramid help to create a safety climate and culture. But it’s not so easy to recognize the importance of what happens to the organization-and, more importantly, what can happen to firefighters’ lives on the fireground-when leaders fail to intervene. If you subscribe to the “predictable is preventable” theory, then it stands to reason that chief and company officers must intervene when safety issues arise on the fireground if we are to reduce injuries and prevent fatalities.

The key ingredient is leaders’ intervention: Chief and company officers must instinctively intervene and stop the potential “train wreck” on the fireground. At any given point in time, chief and company officers with various levels of experience and knowledge are operating on the fireground, which creates situations that make it easier or more difficult to intervene when unsafe operations are occurring. It is always much easier to jump in and stop an unsafe operation when you have in the old mental carousel a slide that you have seen before and tells you that the end result will not be good.

However, we see periodically chief and company officers who freeze or fail to intervene and stop an unsafe operation even though they may have that particular slide in their carousel, they recognize the danger, and they understand the ramifications of the unsafe practice. Why? Is it possible that the culture of the fire department tests leaders’ ability to intervene? Let’s look at some statements firefighters often use when talking about their fire department’s firefighting philosophy:

  • “Ours is an aggressive interior firefighting fire department.”
  • “There is no such thing as a vacant building.”
  • “Let’s go get it!”

These statements really say a lot about where we stand when it comes to justifying why we do what we do. Until these statements are challenged and reevaluated, we will continue to see very talented, knowledgeable, and experienced chief and company officers fail to intervene on the fireground.


How do chief and company officers get to the point that they instinctively intervene and stop unsafe operations and actions on the fireground? First, they must understand the basic things that often become part of the cultural mindset. One of the common denominators is that nearly everyone starts at the task level. Because of the nature and the complexity of all the tasks firefighters must perform, there is little argument that an entry-level firefighter with no experience should be the incident commander of a single-family dwelling fire on his first day of duty. Should someone try to slip in the door with that attitude, we generally address the issue quickly through our use of tradition, structure, unity, and chain of command. The bottom line is that we start at the task level and take great pride in performing our firefighter tasks skillfully. We “set the hook” with firefighters early in their career. In addition, supervisors and peers constantly evaluate how well the tasks are performed. The peer pressure is often underestimated. Often, the answer to the question of how good a firefighter is Joe or Jane Smith is based on how well each performs under pressure and the risks each is willing to take or has taken.


Because of this early socialization to the task-level mindset, when things go wrong on the fireground, we seem to have an almost automatic task-level response that causes us to do the same or wrong thing harder. This task-level response often prevents us from determining where the real problem is. Often, the problem is not at the task level but at the strategic or tactical level. By not addressing the problem where it is occurring, we continue to make the same mistakes that injure and kill firefighters.

It is imperative to understand that the culture of a fire department is much stronger than we realize. Chief and company officers must take this into account and should have a systematic process for assessing risk on the fireground. They can get a good feel for how strong their fire department culture of safety is by observing fireground operations and communication. They need to look at what is going on and to match their observations with the principles of risk that Chief (Ret.) Alan Brunacini, Phoenix (AZ) Fire Department, made popular and pertinent within the fire service: “Risk a lot to save a lot. Risk a little to save a little. Risk nothing to save nothing.”

It is amazing that so simple a concept can be so difficult to achieve. This, in itself, is a perfect example of how powerful the culture of safety can be. It’s real simple. If fireground operations are not matching these simple standardized principles of risk, then the culture may be winning the war. The only solution to this problem is for chief and company officers to use leadership intervention to change the culture. If leaders in the fire service don’t start making sure the fireground operations match those standardized principles of risk, we can forget about reducing injuries and fatalities. Technological advances in personal protective clothing and various types of tools have helped to protect firefighters, but, as previously stated, strong leadership is the linchpin for establishing a culture of safety, and it is not a mission for the meek.


Because the fireground is constantly changing, the systematic process for determining risk needs to be dynamic. Let’s call it “Dynamic Risk Assessment” or DRA. Its key elements are to identify the hazards, identify who is at risk, assess the risks associated with the hazards, and apply the effective measures that will control the risk. We must embrace and follow the DRA process. If we do not, there will always be the potential that a fire department’s culture could override leadership intervention on the fireground.

It’s easy for chief and company officers to understand these elements, but it’s a whole different ballgame to be committed to following them. Leaders on the fireground have to be willing to embrace these elements and employ leadership intervention when fireground operations are jeopardized by the cultural mindset.

The DRA process is simple in concept but continues to plague fire service leaders on the fireground. These steps are rooted in the belief that the DRA cannot be adequately performed until a visual and mental picture of the fire building has been obtained. It is imperative that a 360° observation be obtained to make a sound decision about the level of risk. Why is it that some chief and company officers make risk decisions and announce strategies and tactics based on incomplete information? Is it possible that the fire service culture that so loudly says “Let’s go get it” overrides the leaders’ ability to demand that resources will be committed and strategies and tactics will be selected only after they have complete information on all six sides of the fire? Is it possible that it is just too difficult to wait a few extra seconds to collect that information before committing the troops?


Chief and company officers have to accomplish many things quickly on the fireground. They have to go through a specific process in a short time. Before the troops can be deployed, they must assume command; consider the critical fireground factors; evaluate the completed DRA; match a strategy to the DRA; formulate an incident action plan that addresses the three tactical priorities of rescue, fire control, and property conservation; and deploy the troops.

First and foremost, however, we must develop fire service leaders whose leadership abilities on the fireground will dominate over a culture that says, “Let’s go get it.” Such leadership exemplifies the professionalism our firefighters and our communities deserve.

MIKE ALDER is a battalion chief and 24-year veteran of the San Bernardino City (CA) Fire Department. He instructs and presents programs throughout the country on risk assessment on the fireground, leadership and communication in the fire service, truck company and high-rise operations for smaller fire departments, and command and control on the fireground. He has a B.S. degree in business administration and an A.S. degree in fire science.

MAT FRATUS, a 20-year veteran of the fire service, is the deputy chief of the San Bernardino City (CA) Fire Department. He has spent several years as an instructor on topics such as live-fire training, incident command and tactics, leadership, and fireground decision making. He has a B.S. degree in fire administration and is participating in the National Fire Academy’s Executive Fire Officer Program.

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